Intersection of Active Surveillance and Radical Therapy for Prostate Cancer: Opportunities for Focal Therapy in North America

Prostate cancer management has evolved significantly in recent decades, with a focus on balancing active surveillance, focal therapy, and radical treatment. Active surveillance has emerged as the standard for low-risk cases, supported by modern protocols utilizing advanced imaging like MRI and genomic risk assessment. However, there may be men who are not ideal observation candidates, but for whom the benefit of definitive therapy remains unclear. Focal therapy offers a nuanced approach, targeting clinically significant tumor areas while preserving the quality of life, subsequently rendering patients excellent observation candidates. Advancements in diagnostics, including MRI and AI, refine patient selection for focal therapy, optimizing outcomes with minimal morbidity. Focal therapy represents a promising treatment on the continuum of contemporary prostate cancer care, offering personalized treatment while minimizing adverse effects.